Application For Membership

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Application Form

Has your membership even been declined, suspended or revoked from any club? *
Privacy Act 1993

With regard to the privacy act 1993 please read the following before submitting this application form: The Mangere Cosmopolitan Club Inc ("The Club") is collecting this information for their membership database, stored securely onsite.

  1. The information is being collected: a. So the Club and its members can assess the applicants suitability for membership including the transfer of membership. b. So the Clubs officers can administer the operation of the Club and assist other clubs that are members of Clubs New Zealand in similar administration. c. To enable Clubs New Zealand or its agents compile a list of members of all chartered clubs in New Zealand and send to those members promotional, marketing and other material.
  2. The applicant acknowledges by signing this form that they authorize the Club to obtain, check exchange and supply information to members of the Club, Clubs New Zealand and other chartered Clubs.
  3. Under the Privacy Act 1993 applicant is entitled to have access to and request correction of their own personal information held by the Club about the applicant.
  4. The applicant acknowledges by signing this form that he or she has authorized the Club to obtain, check, exchange information with, and supply information to members of the Club, Clubs NZ and other Clubs that are members of Clubs NZ.

I Hereby acknowledge that i have read and understood the conditions above. I agree to abide by the rules of the club and certify that the information supplied on this form is correct. I acknowledge that if i have given false information it my result in automatic cancellation of my membership.

Do you agree with the above statment? *
Please accept the Privacy Act 1993 to complete the application.